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Laura's GI Pathology > Pathology of the Stomach > Flashcards

Pathology of the Stomach Flashcards

1
Q

What causes acute gastritis?

A

Irritant chemical injury
systemic disease
severe burns

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2
Q

What are the main groups of causes of chronic gastritis?

A

Autoimmune (rarest)
Bacterial (H. Pylori)
Chemical

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3
Q

Give 3 rare inflammatory disorders of the stomach

A

Lymphocytic
Eosinophilic
Granulomatous

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4
Q

Which antibodies cause autoimmune chronic gastritis?

A

Anti-parietal and anti-intrinsic factor antibodies

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5
Q

What happens in autoimmune chronic gastritis?

A

There is an attack on the lining or products of stomach excretion by the immune system

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6
Q

Where does H. pylori inhabit a niche?

A

between the epithelial cell surface and mucous barrier

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7
Q

What happens if H. pylori is not cleared?

A

A chronic active inflammation ensues which damages epithelial cells and can lead to ulcers

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8
Q

H. pylori gastritis increases the risk of what?

A

Duodenal ulcer
Gastric ulcer
Gastric lymphoma
Gastric carcinoma

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9
Q

What causes chemical gastritis?

A

NSAIDs
alcohol
bile reflux

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10
Q

What happens in chemical gastritis?

A

There is direct injury to mucus layer by fat solvents

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11
Q

What is peptic ulceration?

A

a breach in the gastrointestinal mucosa as a result of acid and pepsin attack

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12
Q

Sites of chronic peptic ulcers

A

1st part of the duodenum
Stomach (junction of body and antrum
Oesophago-gastric junction
Stomal ulcers

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13
Q

What are the 2 parts of the pathogenesis of chronic peptic ulcers?

A

Increased acid production

Failure of mucosal defence

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14
Q

What is the morphology of peptic ulcers?

A 
2-10cm across
edges are clear cut, punched out 
flat along margin - benign 
raised rolled edge - malignant 
once established, inability to repair means they get larger and larger
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15
Q

What is the deepest layer of a peptic ulcer?

A

Fibrotic scar tissue

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16
Q

Complications of peptic ulcers

A 
Perforation 
Penetrations 
haemorrhage 
stenosis 
intractable pain
17
Q

Primary malignant gastric tumours

A

carcinomas (adenocarciomas)
lymphomas
gastrointestinal stromal tumours (rarest)

18
Q

Premalignant conditions to gastric adenocarcioma

A
  • Pernicious anaemia – automimmune gastritis
  • Partial gastrectomy
  • HNPCC / Lynch syndrome – familial
  • Menetrier’s Disease
19
Q

Describe an intestinal type gastric adenocarcinoma

A

discrete localised mass

20
Q

Describe a diffuse type gastric adenocarcinoma

A

epands/infiltrates stomach wall
cannot be removed surgically
poor prognosis

21
Q

Which type of gastric adenocarcinoma (intestinal or difffuse) has a slightly better prognosis?

A

Intestinal type

22
Q

How do gastric adenocarcinomas spread?

A

Local
Lymph nodes
Haematogenous (to the liver)

23
Q

What are Maltomas (type of gastric lymphoma) derived from?

A

mucosa associated lymphoid tissue (MALT)

24
Q

What happens in a maltoma?

A

lymphocytes destroy the gastric epithelium by attacking crypts one by one

25
Q

What is a gastrointestinal stromal tumour (GIST)?

A

Neoplasma of connective tissue of stomach

Can arise in oesophagus and small bowel but rare

26
Q

What are the symptoms an signs of gastric cancer?

A 
Dyspepsia 
upper GI haemorrhage 
weight loss 
abdominal mass 
jaundice (if compresses bile duct) 
Paraneoplastic syndromes (hyperthyroidism can occur)
27
Q

What investigations are used to diagnose gastric cancer?

A

Upper Gi endoscopy and biopsy #1
barium meal
CT/MRI scan

28
Q

Why is surgery carried out in gastric cancer?

A

For palliation of symptoms

for improved survival

29
Q

Contraindications to gastric cancer surgery

A

widely metastatic disease
malignant ascites
brief life expectancy

30
Q

If the gastric cancer was in a distal lesion what kind of surgery would be carried out?

A

Partial gastrectomy

31
Q

If the gastric cancer was in a proximal lesion what kind of surgery would be carried out?

A

total gastrectomy

32
Q

What is the 5 year survival rate of gastric cancer? Does it increase if the pt has surgery?

A

15%

Yes, increases to 40-50%

33
Q

Gastric ulceration usually occurs with normal or low acid production. True or false.

A

True

34
Q

What is gastric adenocarcinoma associated with?

A

H. pylori infection
achlorhydria
pernicious anaemia

Laura's GI Pathology (13 decks)

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